The Impact on the Clinical Prognosis of Low Serum Selenium Level in Patients with Severe Trauma: Systematic Review and Meta-Analysis.

This study was designed to examine the most up-to-date evidence about how low plasma selenium (Se) concentration affects clinical outcomes, such as mortality, infectious complications, and length of ICU or hospital stay, in patients with major trauma. We searched three databases (MEDLINE, EMBASE, and Web of Science) with the following keywords: "injury", "trauma", "selenium", and "trace element". Only records written in English published between 1990 and 2021 were included for analysis. Four studies were eligible for meta-analyses. The results of the meta-analysis showed that a low serum selenium level did not exert a negative effect on the mortality rate (OR 1.07, 95% CI: 0.32, 3.61, p = 0.91, heterogeneity, I2 = 44%). Regarding the incidence of infectious complications, there was no statistically significant deficit after analyses of the four studies (OR 1.61, 95% CI: 0.64, 4.07, p = 0.31, heterogeneity, I2 = 70%). There were no differences in the days spent in the ICU (difference in means (MD) 1.53, 95% CI: -2.15, 5.22, p = 0.41, heterogeneity, I2 = 67%) or the hospital length of stay (MD 6.49, 95% CI: -4.05, 17.02, p = 0.23, heterogeneity, I2 = 58%) in patients with low serum Se concentration. A low serum selenium level after trauma is not uncommon. However, it does not negatively affect mortality and infection rate. It also does not increase the overall length of ICU and hospital stays.

The Impact of Selenium Supplementation on Trauma Patients-Systematic Review and Meta-Analysis.

This study aimed to assess current evidence regarding the effect of selenium (Se) supplementation on the prognosis in patients sustaining trauma. MEDLINE, Embase, and Web of Science databases were searched with the following terms: "trace element", "selenium", "copper", "zinc", "injury", and "trauma". Seven studies were included in the meta-analysis. The pooled results showed that Se supplementation was associated with a lower mortality rate (OR 0.733, 95% CI: 0.586, 0.918, p = 0.007; heterogeneity, I2 = 0%). Regarding the incidence of infectious complications, there was no statistically significant benefit after analyzing the four studies (OR 0.942, 95% CI: 0.695, 1.277, p = 0.702; heterogeneity, I2 = 14.343%). The patients with Se supplementation had a reduced ICU length of stay (standard difference in means (SMD): -0.324, 95% CI: -0.382, -0.265, p < 0.001; heterogeneity, I2 = 0%) and lesser hospital length of stay (SMD: -0.243, 95% CI: -0.474, -0.012, p < 0.001; heterogeneity, I2 = 45.496%). Se supplementation after trauma confers positive effects in decreasing the mortality and length of ICU and hospital stay.